MEDICARE: SLEEP MEDICINE ASSOCIATES OF TEXAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1366084378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEP MEDICINE ASSOCIATES OF TEXAS

Provider Business Mailing Address
First Line	:	5477 GLEN LAKES DR STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4381
Country	:	US
Telephone Number	:	214-750-7776
Fax Number	:

Provider Business Practice Location Address
First Line	:	997 RAINTREE CIR STE 140
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-4950
Country	:	US
Telephone Number	:	214-750-7776
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE COORDINATOR
Name	:	MARIA HOGUE
Credential	:
Telephone Number	:	214-750-7776

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	10/10/2019

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